SEPTIC ARTHRITIS CAUSED BY KINGELLA-KINGAE - DIAGNOSTIC-VALUE OF MODERN MICROBIAL TESTING

Kingella kingae has occasionally been isolated from joint fluid of chi ldren with septic arthritis in europe. K. kingae, a gramnegative bacil lus of the Neisseriaceae family, shows a slow fastidious growth in cul ture. The detection rate can be improved by inoculation of joint fluid aspirates into aerobic blood culture bottles and through a longer cul ture time. K. kingae colonizes the mucous membranes of the upper respi ratory tract. However, osteomyelitis, septic arthritis and meningitis have also been described in childhood. Case report: We report on a 15- months-old girl with a septic arthritis of the left knee and a concomi tant airway infection. Bacterial cultures of joint fluid were negative during the first week. However 16S ribosomal DNA analysis by PCR reve aled K. kingae as the causative agent. Conclusion: Since K. kingae is difficult to detect by conventional microbial methods, detection can b e optimized by bacterial 16S ribosomal DNA-analysis using PCR techniqu e. This technique might be the high percentage of undiagnosed pathogen s in septic arthritis and osteomyelitis.